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Read on as we unpack how menopause can make it harder to catch your zzzs, plus which menopause and sleep treatments are worth your money and time.
For many of us, when we think of menopause, symptoms like hot flashes, mood swings, and weight gain immediately come to mind. But did you know that one of the most common symptoms of menopause and perimenopause is difficulty sleeping?
In fact, aabout 61% of postmenopausal women have sleep problems, according to the National Sleep Foundation.
The good news is that if you’re tossing and turning all night, you don’t have to put up with it. Keep reading to find out about treatments for menopause-related sleep problems that in fact to work. Do you have trouble sleeping? Don’t miss our guide to treating insomnia, while you’re here.
What is the connection between menopause and sleep?
First, let’s explore what causes menopause — and its associated sleep issues — in the first place.
As women or menstruating people age, their ovaries begin to produce less estrogen and progesterone. These are the female hormones that regulate menstruation and their decline leads to the cessation of menstruation (menopause is usually diagnosed after twelve months without menstruation).
But estrogen and progesterone have other important effects on the brain, like helping us fall asleep and stay asleep. Each of these hormones plays different roles in our sleep-wake cycle. For example, progesterone can help us relax, while estrogen can help keep our body temperature at the level we need.
“The majority of women who are in perimenopause or menopause have trouble sleeping, but many don’t realize that these are directly related to the low hormone levels that occur,” says Doctor Louise Newson, general practitioner, renowned menopause specialist and founder of the menopause assistance app, balance.
“Estrogen levels tend to be lowest early in the morning, which is why that’s a particularly bad time for many women going through perimenopause and menopause,” she continues.
What causes sleep problems?
Low levels of estrogen and progesterone can cause several symptoms that can interrupt a good night’s sleep. “Some women have trouble falling asleep while others wake up several times during the night,” explains Catherine Pinkhamfounder of The Insomnia Clinic, one of the only specialist insomnia services in the UK. These symptoms include:
- Hot flashes or night sweats
- restless legs
- Heart palpitations
Pinkham explains that night sweats are the most common trigger. “Hot flashes and the resulting poor sleep can turn our bed into a place of panic as we try to cool off,” she said. said. “You try to calm down and go back to sleep, but your mind races and you can’t calm down.”
She continues: “The next day you feel tired and emotional and you desperately need a good night’s sleep to feel well rested, but at night the pattern repeats itself, and you’re fed up and worried about the impact it has on you. Unfortunately, this can then become a vicious cycle.
What types of treatment are there for menopause and sleep?
There are plenty of sleeping pills and tips, from products like soothing teas and sleep sprays, to sleep hygiene tips like quitting caffeine or putting away screens before bed. “The reality is that we don’t actually need any of these things to sleep well,” says Pinkham. “They can even get in the way and distract from something which is actually a very natural process.”
Especially if your insomnia is caused by anxiety, these “quick fixes” could make it worse, warns Kathryn. This is because the more we try to sleep, the more anxious we can become. Trying to reframe negative thinking is also likely to make things worse, as it is impossible to switch off our mind.
Two main medically approved forms of treatment for menopause-related insomnia are cognitive behavioral therapy for insomnia and hormone replacement therapy. Let’s examine them in more detail.
Cognitive-behavioral therapy for insomnia (CBT-i)
CBT for insomnia (CBT-i) is a type of talk therapy and treatment recommended by the NHS. By learning tools to help manage our thoughts and relieve sleep pressure, CBT-i helps people learn new behaviors and thought patterns that encourage a quality night’s rest. In fact, according to Pinkham, up to 80% of people experience improved sleep after treatment.
“Although the reasons for lack of sleep are different, insomnia caused by menopause follows a similar pattern to insomnia triggered by any other event,” says Pinkham. “CBT allows us to address not the trigger of the problem, but the habits, behaviors and thoughts that maintain it.”
Your doctor may be able to refer you to a free CBT-i course through the NHS, while seeing a private CBT therapist will likely cost £50 or more per session. Another option is Pinkham’s Sleep well during menopause online course, which currently costs £225 and includes everything you would receive in face-to-face sessions.
Hormone replacement therapy (HRT)
HRT was once a source of controversy, largely because of a (now debunked) 2001 study that suggested the treatment led to a higher risk of breast cancer. Nowadays it is widely accepted that the benefits outweigh the associated risks and HRT should be available over the counter in the UK.
What is HRT?
Essentially, HRT replaces hormones that decline during menopause. This means it can improve a range of symptoms, from sleep and mood swings to reduced libido. The drug comes in various forms, such as a tablet, patch, gel, or cream.
“Menopause is a hormone deficiency so the optimal treatment is hormone replacement,” says Dr. Newson. “There are different types and doses and it is important that women receive individualized treatment. The majority of women who take the right dose and type of HRT for them find that their sleep actually improves.
1. Always talk to your doctor if you are having difficulty
They will be happy to discuss treatment options with you and help you decide what is best for you.
2. Don’t fall into the trap of quick fixes
As Pinkham points out, you shouldn’t need any special products or strict rules to get your 40 winks. It’s best to get to the root of your sleep problems with CBT-i or HRT.
3. Get the support you need from family, friends, and your workplace
Sleep is essential for maintaining our sense of well-being, and not getting enough of it can impact many areas of our lives.
Try this: Make sure your family, friends, and workplace know what you’re going through so you can get the support you deserve.
4. Know that this is totally normal
Menopause is a natural and inevitable part of every woman’s life, so know that whatever symptoms you are experiencing, you will be in very good company. Fortunately, more and more women are beginning to challenge the taboo and talk about their own menopause experiences.
Remember: we can all do our part to keep the conversation going.